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Individual

COURTNEY SPARKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
651 TAYLOR DR, XENIA, OH 45385-7246
(937) 352-1269
Mailing address
4142 E US HIGHWAY 136, PITTSBORO, IN 46167-9046

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
11/04/2015
Last updated
01/10/2017
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